| NPI | 1962165217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL APRN11033481) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP024558) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2024-06-24 |