NPI | 1154634723 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305368) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1503092) |
Enumeration Date | 2010-07-23 |
Last Update Date | 2021-10-15 |