| NPI | 1740348325 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11008235)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9444091)  | 
| Enumeration Date | 2006-12-05 | 
| Last Update Date | 2021-04-25 |