NPI | 1093103780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340330) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 690794-1) |
Enumeration Date | 2015-01-02 |
Last Update Date | 2016-02-25 |