NPI | 1306511951 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021019793) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023319) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2021019793) | |
Enumeration Date | 2021-08-14 |
Last Update Date | 2024-09-06 |