NPI | 1356797633 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017011) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA 60639427) |
Enumeration Date | 2016-05-05 |
Last Update Date | 2024-10-04 |