NPI | 1083007579 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020589) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 339511) |
363LF0000X Nurse Practitioner, Family (Licence: NY 33 339511) | |
Enumeration Date | 2015-03-09 |
Last Update Date | 2024-08-15 |