NPI | 1457869992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SD CP002091) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.001336) |
Enumeration Date | 2018-01-18 |
Last Update Date | 2024-01-09 |