NPI | 1669240735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023048645) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209029501) |
Enumeration Date | 2023-12-18 |
Last Update Date | 2024-10-23 |