NPI | 1548802630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 353345) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00952000) |
Enumeration Date | 2019-10-10 |
Last Update Date | 2025-07-15 |