| NPI | 1619634672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016702) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1138159) |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2024-02-07 |