NPI | 1609425081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180261) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F345006-01) |
Enumeration Date | 2019-09-09 |
Last Update Date | 2022-10-26 |