| NPI | 1801311642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9166879) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9166879) |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2019-11-04 |