| NPI | 1962038380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL APRN11006538) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006538) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-09-01 |