| NPI | 1104222405 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9172898) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 9172898) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9172898) | |
| Enumeration Date | 2014-11-13 | 
| Last Update Date | 2023-02-10 |