NPI | 1053836106 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016833) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-016833) |
Enumeration Date | 2017-08-10 |
Last Update Date | 2024-08-30 |