| NPI | 1205498078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11003194) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: FL RN9390112) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2020-01-28 |