NPI | 1568814432 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014644) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A178667) |
Enumeration Date | 2016-07-05 |
Last Update Date | 2024-05-01 |