NPI | 1659865129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23884) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018018089) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209017701) | |
Enumeration Date | 2018-06-19 |
Last Update Date | 2024-11-15 |