NPI | 1043649890 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354755) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 310094-1) |
163W00000X Registered Nurse (Licence: NY 771135) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: NY 354755) | |
Enumeration Date | 2013-11-02 |
Last Update Date | 2024-08-16 |