NPI | 1598213548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009458) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 345407) |
363LF0000X Nurse Practitioner, Family (Licence: CT 7918) | |
Enumeration Date | 2016-09-20 |
Last Update Date | 2024-12-22 |