NPI | 1154549632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 8816) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30304076) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2021-11-01 |