NPI | 1114417615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 882636) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017607) |
Enumeration Date | 2018-05-10 |
Last Update Date | 2025-06-24 |