NPI | 1376764563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006947) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-006544) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2023-10-24 |