NPI | 1053989301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349887) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014534) |
Enumeration Date | 2021-06-14 |
Last Update Date | 2023-07-17 |