| NPI | 1902406598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11010083) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN425512) |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2022-10-13 |