| NPI | 1962691717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN2876412) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2876412) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP2876412) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2019-12-04 |