NPI | 1760487839 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-000723) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-083274) |
Enumeration Date | 2005-06-16 |
Last Update Date | 2015-02-05 |