| NPI | 1700420312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11004104) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9415371) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |