NPI | 1972934503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339362-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 657168-1) |
Enumeration Date | 2013-12-08 |
Last Update Date | 2017-04-24 |