NPI | 1073255303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024096) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041336600) |
163WE0003X Registered Nurse, Emergency (Licence: FL 9585725) | |
363LF0000X Nurse Practitioner, Family (Licence: IL 209.027004) | |
Enumeration Date | 2022-04-07 |
Last Update Date | 2023-03-28 |