| NPI | 1972159697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003854) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9356918) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-27 |