| NPI | 1932670247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002023) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN155906) |
| Enumeration Date | 2018-12-12 |
| Last Update Date | 2022-03-09 |