NPI | 1083303739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028858) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.447466) |
Enumeration Date | 2023-05-08 |
Last Update Date | 2024-02-16 |