| NPI | 1972912897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R864333) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9291294) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2016-03-07 |