NPI | 1275061525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F345560-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 677) |
Enumeration Date | 2017-05-31 |
Last Update Date | 2022-07-21 |