NPI | 1366020950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021003532) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022811) |
Enumeration Date | 2021-04-01 |
Last Update Date | 2021-04-01 |