NPI | 1407148836 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340641) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0076965) |
Enumeration Date | 2011-05-04 |
Last Update Date | 2022-12-12 |