| NPI | 1053201038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11040639) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11040639) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-09-30 |