| NPI | 1821562745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11009334) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9467755) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2020-10-07 |