NPI | 1053078386 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10269) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F348311) |
Enumeration Date | 2021-11-22 |
Last Update Date | 2022-10-19 |