NPI | 1619573425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346630) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10175) |
Enumeration Date | 2020-12-07 |
Last Update Date | 2021-12-05 |