NPI | 1124177647 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A074701) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277000125) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2019-12-16 |