NPI | 1548714140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349919-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 225525257) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2022-07-29 |