| NPI | 1679031181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN3422342) |
| Additional Taxonomies | 2088P0231X Urology Pediatric Urology (Licence: FL APRN3422342) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |