| NPI | 1104158161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9485528) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN280065) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2020-09-14 |