NPI | 1083917330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010040484) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020692) |
Enumeration Date | 2010-12-08 |
Last Update Date | 2022-05-13 |