| NPI | 1861864951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9300760) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL ARNP9300760) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL ARNP9300760) | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2021-09-27 |