NPI | 1114436771 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006516) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308422-1) |
Enumeration Date | 2017-09-27 |
Last Update Date | 2021-10-04 |