NPI | 1639605298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 483096-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F335027-1) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2020-12-02 |