| NPI | 1528669512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11010166) | 
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: FL RN9278927) | 
| Enumeration Date | 2020-11-05 | 
| Last Update Date | 2021-04-16 |