| NPI | 1912542309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11004609) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11004609) |
| Enumeration Date | 2019-11-09 |
| Last Update Date | 2021-02-17 |