NPI | 1730725458 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11012242) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP021102) |
Enumeration Date | 2019-11-18 |
Last Update Date | 2024-01-17 |