| NPI | 1457220279 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11044217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN200185) |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2025-12-17 |