NPI | 1609282193 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339468) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 674223) |
363LF0000X Nurse Practitioner, Family (Licence: HI APRN2046) | |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2322673) | |
Enumeration Date | 2014-07-07 |
Last Update Date | 2023-01-22 |