| NPI | 1972173813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN258419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.25142) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC RN258419) | |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2025-03-27 |