| NPI | 1700513769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11013207) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9493331) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2024-06-10 |