NPI | 1184032559 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011634) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209011634) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2019-12-20 |