| NPI | 1487931077 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP3249032) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN3249032) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2025-02-05 |