| NPI | 1306452693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010777) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP11010777) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2021-08-18 |