NPI | 1972050623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015483) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 152313-30) |
Enumeration Date | 2016-09-09 |
Last Update Date | 2017-03-01 |