NPI | 1316672793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349885) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 349885) |
Enumeration Date | 2022-07-20 |
Last Update Date | 2023-07-22 |