| NPI | 1376190785 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003785) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 3-000409) | 
| Enumeration Date | 2019-08-20 | 
| Last Update Date | 2024-05-04 |