NPI | 1407403348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A155984) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020089) |
Enumeration Date | 2019-08-26 |
Last Update Date | 2024-03-13 |