| NPI | 1992015705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11001910) |
| Additional Taxonomies | 111NR0400X (Licence: FL MA46118) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2021-09-09 |