| NPI | 1619482957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9476047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-106760) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 21228) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9476047) | |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2024-11-05 |