| NPI | 1861859076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9331644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9331644) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2019-12-10 |