NPI | 1154702702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9920) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 339567) |
Enumeration Date | 2015-06-09 |
Last Update Date | 2022-07-19 |