NPI | 1578008769 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-016197) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.016197) |
Enumeration Date | 2016-12-27 |
Last Update Date | 2024-11-01 |