| NPI | 1104234798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9171670) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9171670) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9171670) | |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2021-02-16 |