NPI | 1326619131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F355664-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 800613) |
Enumeration Date | 2021-07-03 |
Last Update Date | 2025-01-24 |