NPI | 1134403637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009159) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A114523) |
Enumeration Date | 2011-10-03 |
Last Update Date | 2015-03-09 |