NPI | 1760215214 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024018926) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209029804) |
Enumeration Date | 2024-08-21 |
Last Update Date | 2024-08-21 |