| NPI | 1538712013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL RN9347733) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: FL RN9347733) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |