NPI | 1124436506 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F338738-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R220990) |
363LF0000X Nurse Practitioner Family (Licence: MA RN187857) | |
Enumeration Date | 2014-07-29 |
Last Update Date | 2021-08-17 |