NPI | 1104354257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016471) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041379918) |
Enumeration Date | 2017-06-01 |
Last Update Date | 2022-07-21 |