NPI | 1780980201 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R218153) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336619) |
Enumeration Date | 2011-01-31 |
Last Update Date | 2021-02-15 |