NPI | 1306828140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-005558(41-307571) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4447P) |
Enumeration Date | 2005-11-17 |
Last Update Date | 2016-08-30 |