| NPI | 1710503602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007430) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2023-03-22 |