NPI | 1598311433 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025452) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F34462601) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95015045) | |
Enumeration Date | 2019-08-15 |
Last Update Date | 2022-09-27 |