NPI | 1811635261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 351713) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11039243) |
363LF0000X Nurse Practitioner, Family (Licence: AZ 226316) | |
Enumeration Date | 2022-05-25 |
Last Update Date | 2025-07-09 |