NPI | 1073996336 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000681) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340467) |
Enumeration Date | 2015-07-06 |
Last Update Date | 2019-04-05 |