NPI | 1164972063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307983) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 307983) |
Enumeration Date | 2016-10-04 |
Last Update Date | 2023-06-29 |