| NPI | 1336718253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008621) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11008621) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-24 |