NPI | 1013253699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017395) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012013994) |
Enumeration Date | 2012-12-30 |
Last Update Date | 2018-05-14 |