NPI | 1083156376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017316) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28189189A) |
Enumeration Date | 2016-11-17 |
Last Update Date | 2018-06-13 |