NPI | 1407269400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346512) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F346512-01) |
Enumeration Date | 2014-06-06 |
Last Update Date | 2025-01-28 |