NPI | 1225417876 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015993) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN161827) |
Enumeration Date | 2015-05-28 |
Last Update Date | 2018-07-16 |