| NPI | 1568096279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11034876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN196865) |
| 363L00000X Nurse Practitioner (Licence: TX AG02200003) | |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2024-11-14 |