NPI | 1578257069 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352037) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019189) |
Enumeration Date | 2023-06-07 |
Last Update Date | 2024-12-16 |