| NPI | 1891275459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11002540) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL AG04180003) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2019-08-26 |