NPI | 1508236464 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19036) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011706) |
Enumeration Date | 2015-10-04 |
Last Update Date | 2020-06-10 |