NPI | 1740210004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016382) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 11756) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2019-11-04 |