NPI | 1932656568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020169) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014708) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2022-07-11 |