| NPI | 1063001808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11011219) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 648194) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-10-21 |