| NPI | 1790115087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL RN9242686) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL RN9242686) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2013-11-22 |