NPI | 1861965543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1133284) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209018494) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209018494) | |
Enumeration Date | 2019-01-06 |
Last Update Date | 2024-01-11 |