NPI | 1124513635 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018091) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IL 041331639) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2022-06-23 |