| NPI | 1215539507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: FL APRN11017829) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MA RN2328969) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MA RN2328969) | |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2022-08-30 |