| NPI | 1548865751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010775) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 647315) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2021-01-21 |