| NPI | 1780199604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9338761) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: FL APRN9338761) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2024-07-11 |