| NPI | 1578211199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11019300) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL AG01220040) |
| Enumeration Date | 2022-03-13 |
| Last Update Date | 2022-08-23 |