NPI | 1972088979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R256059) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343457) |
Enumeration Date | 2018-09-26 |
Last Update Date | 2024-10-28 |