NPI | 1831479864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343606-1) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 002776-1) |
Enumeration Date | 2011-08-22 |
Last Update Date | 2019-01-22 |