NPI | 1275310377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028327) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028560) |
Enumeration Date | 2023-09-12 |
Last Update Date | 2024-03-27 |