NPI | 1003505314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029582) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.497979) |
Enumeration Date | 2023-05-03 |
Last Update Date | 2024-11-17 |