NPI | 1134644503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008862) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F341988-1) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2022-07-21 |