NPI | 1780041848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180551) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 651820) |
363LF0000X Nurse Practitioner, Family (Licence: NY 2017010551) | |
363LF0000X Nurse Practitioner, Family (Licence: NY 341996-1) | |
Enumeration Date | 2016-01-20 |
Last Update Date | 2021-03-19 |