NPI | 1306466313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022190) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.424604) |
Enumeration Date | 2020-04-20 |
Last Update Date | 2022-07-06 |