NPI | 1154314920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 303794) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 303794) |
Enumeration Date | 2005-08-26 |
Last Update Date | 2021-05-31 |