NPI | 1124360862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306836) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659467-1) |
Enumeration Date | 2013-03-20 |
Last Update Date | 2018-04-11 |