NPI | 1255603312 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352249) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 308353) |
Enumeration Date | 2012-02-06 |
Last Update Date | 2024-08-01 |