| NPI | 1922566132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11033123) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001238055) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177396) | |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2025-01-09 |