NPI | 1366030371 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346621) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 346621) |
Enumeration Date | 2021-01-05 |
Last Update Date | 2023-07-07 |