NPI | 1639106651 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9228952) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY NYS330384) |
Enumeration Date | 2006-06-26 |
Last Update Date | 2007-09-20 |