| NPI | 1982186003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN109314) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22285) |
| 363L00000X Nurse Practitioner (Licence: SC NCO000008) | |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2024-08-22 |