NPI | 1376131227 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN305653) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209022453) |
Enumeration Date | 2021-01-06 |
Last Update Date | 2024-04-03 |