| NPI | 1285932806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11018473) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9406150) |
| 174400000X Specialist (Licence: FL FB9727235) | |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2022-03-04 |