NPI | 1356823033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010927) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343002) |
Enumeration Date | 2018-08-30 |
Last Update Date | 2018-09-20 |