NPI | 1275051906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343555) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007208) |
Enumeration Date | 2017-09-01 |
Last Update Date | 2019-05-15 |