NPI | 1164942330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308571-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 604002-1) |
Enumeration Date | 2017-06-20 |
Last Update Date | 2024-03-28 |