NPI | 1881071421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9441800) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 584482-1) |
363LF0000X Nurse Practitioner, Family (Licence: NY F338150-1) | |
Enumeration Date | 2015-05-04 |
Last Update Date | 2024-06-30 |