NPI | 1063183952 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN308064) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024022) |
Enumeration Date | 2021-09-21 |
Last Update Date | 2025-05-20 |