NPI | 1609362623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011912) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343257) |
Enumeration Date | 2018-07-02 |
Last Update Date | 2024-11-18 |