NPI | 1265418313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-001033) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 727466) |
Enumeration Date | 2005-12-21 |
Last Update Date | 2010-08-18 |