NPI | 1679817118 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337660-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012083) |
Enumeration Date | 2012-11-21 |
Last Update Date | 2016-11-14 |