| NPI | 1619349305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL PA9109058) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109058) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2025-06-25 |