| NPI | 1871916759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11012772) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9297557) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2022-03-27 |