| NPI | 1508525452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016860) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: FL APRN11016860) | 
| Enumeration Date | 2021-12-08 | 
| Last Update Date | 2021-12-08 |