| NPI | 1740765130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11000472) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9370029) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2020-05-11 |