NPI | 1356035315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4007047) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209027349) |
Enumeration Date | 2023-06-05 |
Last Update Date | 2023-11-28 |