NPI | 1093475881 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F310169-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 689253-01) |
Enumeration Date | 2021-12-21 |
Last Update Date | 2021-12-21 |