| NPI | 1992044762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9449571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17410) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN229640) | |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2023-01-25 |