NPI | 1629043849 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 133429) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209000687) |
363L00000X Nurse Practitioner (Licence: MO 133429) | |
Enumeration Date | 2006-02-21 |
Last Update Date | 2016-11-08 |