NPI | 1558302836 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7494) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F3814881) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7494) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2019-11-21 |