| NPI | 1861626764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11011208) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-76178) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 3871) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2022-12-22 |