NPI | 1053493817 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338220-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-004412) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2015-07-17 |