NPI | 1578748661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP009652) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ NJ00281000) |
Enumeration Date | 2008-01-08 |
Last Update Date | 2022-07-21 |