NPI | 1265786545 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 545865-1) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9199897) |
363L00000X Nurse Practitioner (Licence: FL A1012090) | |
Enumeration Date | 2012-11-07 |
Last Update Date | 2022-03-28 |