NPI | 1528406212 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33338268) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 5826131) |
Enumeration Date | 2013-06-05 |
Last Update Date | 2018-12-19 |