NPI | 1639163793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334604) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 558428) |
Enumeration Date | 2005-09-06 |
Last Update Date | 2011-08-11 |