NPI | 1003057373 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336603) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 259359) |
Enumeration Date | 2009-03-17 |
Last Update Date | 2011-02-22 |