NPI | 1073049722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277002442) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023314) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209015881) | |
Enumeration Date | 2017-05-02 |
Last Update Date | 2023-05-10 |