NPI | 1245608637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347155-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 705405) |
Enumeration Date | 2015-09-02 |
Last Update Date | 2024-08-13 |