NPI | 1104301753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346819) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NY 456389) |
Enumeration Date | 2018-09-30 |
Last Update Date | 2022-05-17 |