NPI | 1700304508 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009010907) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 0414370057) |
Enumeration Date | 2017-09-01 |
Last Update Date | 2022-07-21 |