| NPI | 1902563844 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016594) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016594) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NV 848663) | |
| Enumeration Date | 2021-11-28 | 
| Last Update Date | 2024-03-13 |