NPI | 1528350212 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.008753) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 209.008753) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2019-01-29 |