NPI | 1386716694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12057) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY f333594-1) |
Enumeration Date | 2006-11-14 |
Last Update Date | 2024-09-13 |