NPI | 1720586688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018491) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704302022) |
Enumeration Date | 2018-01-25 |
Last Update Date | 2019-01-03 |