NPI | 1508098369 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 22 619867) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F356887-01) |
Enumeration Date | 2009-08-12 |
Last Update Date | 2025-09-19 |