NPI | 1417731712 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352926) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11027600) |
Enumeration Date | 2023-08-21 |
Last Update Date | 2025-04-15 |