NPI | 1669211504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.031192) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.475282) |
Enumeration Date | 2024-05-21 |
Last Update Date | 2025-07-03 |