| NPI | 1780148346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11002507) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 112705) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-09-06 |