| NPI | 1104432467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN110099262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11009262) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2022-08-11 |