NPI | 1659980670 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.009813) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 79074) |
163W00000X Registered Nurse (Licence: NY 503718) | |
363LF0000X Nurse Practitioner, Family (Licence: NY 349633) | |
Enumeration Date | 2020-07-27 |
Last Update Date | 2023-12-27 |