| NPI | 1912470196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11025334) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1036955) |
| 363L00000X Nurse Practitioner (Licence: WV APRN86867FNP-BC) | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2023-06-27 |