NPI | 1962785162 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F311261-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 648082) |
Enumeration Date | 2011-09-23 |
Last Update Date | 2024-12-07 |