NPI | 1518405364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11031422) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339484-1) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NJ 26NJ01044200) | |
Enumeration Date | 2017-02-01 |
Last Update Date | 2024-08-20 |