NPI | 1033568910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209014381) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041353692) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2016-06-24 |