NPI | 1336735273 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022542) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020041032) |
Enumeration Date | 2020-12-15 |
Last Update Date | 2022-03-25 |