NPI | 1790707180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004847) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY P330828-1) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2018-06-21 |