NPI | 1124695424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 737165-01) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F347380) |
Enumeration Date | 2021-06-07 |
Last Update Date | 2021-06-07 |