NPI | 1760114342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025322) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11025095) |
Enumeration Date | 2022-06-30 |
Last Update Date | 2024-03-25 |