NPI | 1073003463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-017626) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017626) |
Enumeration Date | 2018-05-11 |
Last Update Date | 2024-06-10 |