| NPI | 1972155109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11002854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002854) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2020-02-25 |