| NPI | 1043806185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11009609) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11009609) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11009609) | |
| Enumeration Date | 2020-12-13 |
| Last Update Date | 2022-09-01 |