NPI | 1720394208 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011496) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.11742-NP) |
Enumeration Date | 2010-08-23 |
Last Update Date | 2014-09-08 |