NPI | 1073093803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018223) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041366750) |
363LF0000X Nurse Practitioner, Family (Licence: WI 9527-33) | |
Enumeration Date | 2018-08-21 |
Last Update Date | 2022-06-06 |