NPI | 1275183931 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9464322) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 100) |
363LF0000X Nurse Practitioner, Family (Licence: NY F345892-01) | |
Enumeration Date | 2019-09-16 |
Last Update Date | 2024-08-12 |