| NPI | 1558923920 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9233692) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4025976) | 
| 163WR0400X Registered Nurse, Rehabilitation (Licence: FL 9233692) | |
| Enumeration Date | 2019-07-05 | 
| Last Update Date | 2024-10-29 |