NPI | 1467646562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5547) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-001119) |
Enumeration Date | 2007-08-31 |
Last Update Date | 2018-03-17 |