NPI | 1124405477 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344325) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6766771) |
Enumeration Date | 2015-05-06 |
Last Update Date | 2020-03-20 |