| NPI | 1104259001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN11005607) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F305770-1) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2020-10-14 |