NPI | 1720052350 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3223) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 175233-1) |
363L00000X Nurse Practitioner (Licence: IL 209000613) | |
363LF0000X Nurse Practitioner, Family (Licence: MN 175233-1) | |
Enumeration Date | 2006-02-13 |
Last Update Date | 2019-04-29 |