| NPI | 1336212380 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 9162696)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2875)  | 
| Enumeration Date | 2006-11-16 | 
| Last Update Date | 2014-04-28 |