| NPI | 1720765803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11027654) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9434382) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-07-20 |