NPI | 1265109409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023957) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A165295) |
Enumeration Date | 2021-08-25 |
Last Update Date | 2023-08-18 |