| NPI | 1902385784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5012512) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9454238) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9454238) | |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2022-03-14 |