NPI | 1083866958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 4950) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 430430) |
363LF0000X Nurse Practitioner, Family (Licence: NY 340465) | |
Enumeration Date | 2008-10-22 |
Last Update Date | 2019-01-25 |