NPI | 1245399419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 301643) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY F301643) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2017-05-09 |