NPI | 1235641804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8929) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209016700) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2019-01-17 |