NPI | 1205389798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP5226) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041401306) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209014637) | |
Enumeration Date | 2016-08-01 |
Last Update Date | 2022-07-21 |