| NPI | 1861821167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL PA9108071) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017101) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2021-03-30 |