NPI | 1083002133 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012314) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 6504) |
Enumeration Date | 2014-12-23 |
Last Update Date | 2019-11-07 |