| NPI | 1972926061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN275763) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2024-07-24 |