NPI | 1124744289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021183) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL 11021183) |
Enumeration Date | 2022-10-19 |
Last Update Date | 2022-12-15 |