NPI | 1508482563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008038) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021491) |
Enumeration Date | 2020-06-24 |
Last Update Date | 2024-03-27 |