NPI | 1154963809 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11015726) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9408793) |
Enumeration Date | 2019-10-15 |
Last Update Date | 2024-01-05 |