NPI | 1194378992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209019703) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: IA A155615) |
Enumeration Date | 2019-07-20 |
Last Update Date | 2021-02-15 |