| NPI | 1104148063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN9217961) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9217961) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2023-07-12 |