NPI | 1356930804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP023057) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F347007-01) |
Enumeration Date | 2021-01-11 |
Last Update Date | 2024-01-25 |