| NPI | 1790352607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11013909) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9362737) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-08-16 |