| NPI | 1164084679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007472) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9210067) |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2024-08-22 |