NPI | 1215561568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309592) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 309592) |
Enumeration Date | 2020-02-26 |
Last Update Date | 2022-05-24 |