NPI | 1669922589 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345904) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 6710) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2300061) | |
Enumeration Date | 2016-10-04 |
Last Update Date | 2024-01-17 |