| NPI | 1063416865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9340627) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 129010) |
| 363L00000X Nurse Practitioner (Licence: TN 129010) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-12-19 |