NPI | 1780067835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7597) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339855-1) |
Enumeration Date | 2015-07-08 |
Last Update Date | 2019-05-16 |