NPI | 1508202045 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.010377) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010377) |
Enumeration Date | 2013-05-10 |
Last Update Date | 2023-02-03 |