NPI | 1114328507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005901) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338443-1) |
Enumeration Date | 2014-09-04 |
Last Update Date | 2021-03-09 |