NPI | 1730732082 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005680) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344673) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2020-04-13 |