NPI | 1073051116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 642391) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346467) |
Enumeration Date | 2017-02-09 |
Last Update Date | 2020-10-30 |