NPI | 1104279215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344477-1) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 683370) |
Enumeration Date | 2016-07-14 |
Last Update Date | 2024-12-03 |