| NPI | 1053701102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD 002466) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024177063) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP3154192) | |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2023-08-22 |