NPI | 1578058301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343169) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP021142) |
Enumeration Date | 2018-06-25 |
Last Update Date | 2024-07-23 |