NPI | 1164863106 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347477-01) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 294815) |
Enumeration Date | 2013-07-06 |
Last Update Date | 2021-12-15 |