NPI | 1972599488 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012110) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F331012) |
Enumeration Date | 2005-09-21 |
Last Update Date | 2024-05-06 |