NPI | 1417618679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11017641) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F348542-01) |
Enumeration Date | 2022-01-10 |
Last Update Date | 2024-05-14 |