| NPI | 1548398902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9480246) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 151092) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9480246) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-25 |