NPI | 1780257824 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 315360) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2334513) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2334513) | |
363LF0000X Nurse Practitioner, Family (Licence: CT 12.011360) | |
Enumeration Date | 2021-07-16 |
Last Update Date | 2024-10-19 |