NPI | 1194205252 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342728-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 008649) |
Enumeration Date | 2018-08-17 |
Last Update Date | 2019-12-17 |