NPI | 1215987318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R140445) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 339007) |
363LF0000X Nurse Practitioner, Family (Licence: MD R140445) | |
Enumeration Date | 2006-05-11 |
Last Update Date | 2019-04-24 |