NPI | 1275098717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016460) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11016460) |
363LF0000X Nurse Practitioner, Family (Licence: NY F342784-1) | |
Enumeration Date | 2019-02-08 |
Last Update Date | 2024-03-22 |