NPI | 1619507597 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 310246) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 779645) |
Enumeration Date | 2020-01-20 |
Last Update Date | 2021-07-09 |