NPI | 1649878919 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025192) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 10371-33) |
Enumeration Date | 2020-10-09 |
Last Update Date | 2022-09-01 |