| NPI | 1205357654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9274983) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9274983) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9274983) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2022-04-22 |