NPI | 1245203272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2000167712) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2000167712) |
363L00000X Nurse Practitioner (Licence: IL 209005424) | |
Enumeration Date | 2006-02-09 |
Last Update Date | 2024-10-03 |