NPI | 1023720455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349666) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720750-01) |
207Q00000X Family Medicine (Licence: NY F349666-01) | |
Enumeration Date | 2022-12-16 |
Last Update Date | 2024-08-14 |