NPI | 1003157751 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338539) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 644089) |
Enumeration Date | 2013-03-05 |
Last Update Date | 2014-07-14 |