NPI | 1457911059 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F310834-01) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ01337000) |
Enumeration Date | 2019-06-17 |
Last Update Date | 2022-08-24 |