NPI | 1235619461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345083) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01455000) |
Enumeration Date | 2018-08-16 |
Last Update Date | 2025-02-06 |