| NPI | 1942955547 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN192339) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 192339) | 
| Enumeration Date | 2022-02-14 | 
| Last Update Date | 2024-05-13 |