NPI | 1093122525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349762) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686918-1) |
Enumeration Date | 2014-07-16 |
Last Update Date | 2024-06-11 |