| NPI | 1902204761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9207347) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9207347) | 
| Enumeration Date | 2014-12-10 | 
| Last Update Date | 2022-05-11 |