NPI | 1134474612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277.000745) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.009343) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2023-10-24 |