NPI | 1316597297 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 11472) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 251826) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NY F309445) | |
Enumeration Date | 2019-09-12 |
Last Update Date | 2024-06-04 |