NPI | 1629732755 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024195) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1051785) |
Enumeration Date | 2021-10-25 |
Last Update Date | 2023-08-10 |