| NPI | 1780263665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11009198) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM 67626) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95021845) | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2022-12-09 |