NPI | 1669036331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 260933) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.01855) |
Enumeration Date | 2019-04-27 |
Last Update Date | 2023-07-31 |