NPI | 1114233509 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 006188) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 632377-1) |
163WG0000X Registered Nurse, General Practice (Licence: CT 96115) | |
Enumeration Date | 2010-08-24 |
Last Update Date | 2019-06-14 |