NPI | 1730787979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348681) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009590) |
Enumeration Date | 2020-10-10 |
Last Update Date | 2025-08-26 |