NPI | 1285380352 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 110187885) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F348017-01) |
Enumeration Date | 2022-02-26 |
Last Update Date | 2022-08-25 |