| NPI | 1912456674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN2860862) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP131777) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2018-12-18 |