NPI | 1114482452 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349869) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: NY 629854) |
Enumeration Date | 2019-01-31 |
Last Update Date | 2022-12-22 |