NPI | 1164848636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM CNP-02937) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-84068) |
163W00000X Registered Nurse (Licence: NY 673201) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307181) | |
Enumeration Date | 2014-03-08 |
Last Update Date | 2019-01-25 |