NPI | 1073952651 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F337239-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337239-1) |
Enumeration Date | 2013-06-18 |
Last Update Date | 2016-11-21 |