| NPI | 1952833543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN295563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00720700) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2024-08-07 |