| NPI | 1821667965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11017758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9447386) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2022-10-18 |