NPI | 1114507332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11026952) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11026952) |
Enumeration Date | 2021-04-12 |
Last Update Date | 2024-02-09 |