NPI | 1578163515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN323946) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022330) |
Enumeration Date | 2020-10-29 |
Last Update Date | 2024-08-07 |