| NPI | 1790391225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11008680) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11008680) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2022-10-20 |