NPI | 1134543267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306754-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 608824-1) |
Enumeration Date | 2014-02-10 |
Last Update Date | 2015-08-06 |