NPI | 1730406133 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006499) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012001) |
363LF0000X Nurse Practitioner, Family (Licence: NY F336105) | |
Enumeration Date | 2010-04-23 |
Last Update Date | 2024-11-15 |