NPI | 1689118143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1019068) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015330) |
Enumeration Date | 2016-12-16 |
Last Update Date | 2024-04-22 |