NPI | 1124309174 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F309691) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 645226-1) |
Enumeration Date | 2011-09-05 |
Last Update Date | 2020-07-15 |