NPI | 1164785200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 11402) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305858-1) |
Enumeration Date | 2012-06-22 |
Last Update Date | 2025-06-09 |