NPI | 1003513284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13555) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209029140) |
363LF0000X Nurse Practitioner, Family (Licence: WI 13555) | |
Enumeration Date | 2023-02-08 |
Last Update Date | 2025-02-24 |