NPI | 1164765921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10409) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 631315) |
363LF0000X Nurse Practitioner, Family (Licence: NY 339489) | |
Enumeration Date | 2013-03-30 |
Last Update Date | 2022-05-20 |