NPI | 1801439740 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 356542) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 220038) |
Enumeration Date | 2019-10-23 |
Last Update Date | 2025-08-28 |