NPI | 1811772791 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 357716) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR22622300) |
Enumeration Date | 2023-08-29 |
Last Update Date | 2025-09-11 |