| NPI | 1730578055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9314175) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9314175) |
| 163W00000X Registered Nurse (Licence: AK 37289) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AK 1513) | |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2019-10-17 |