NPI | 1811396146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181653) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F0714530) |
Enumeration Date | 2014-08-22 |
Last Update Date | 2023-11-02 |