NPI | 1811286305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011006159) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008717) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2021-12-06 |