NPI | 1528474988 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN9340061) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN151120) |
363LF0000X Nurse Practitioner, Family (Licence: FL RN9340061) | |
Enumeration Date | 2014-07-07 |
Last Update Date | 2019-03-14 |