NPI | 1174288773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 266654) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209022899) |
Enumeration Date | 2021-11-08 |
Last Update Date | 2025-05-13 |