NPI | 1013456334 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021939) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005480) |
363LF0000X Nurse Practitioner, Family (Licence: NY 342228) | |
Enumeration Date | 2017-02-20 |
Last Update Date | 2021-02-02 |