NPI | 1962851550 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN815052) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014041) |
Enumeration Date | 2016-06-06 |
Last Update Date | 2019-01-28 |