NPI | 1508240185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 19303) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012752) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2022-04-20 |