NPI | 1205350915 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016238) |
Enumeration Date | 2017-08-03 |
Last Update Date | 2023-10-05 |