| NPI | 1164579868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN9342254) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F303615-1) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-01-17 |