NPI | 1134610942 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017686) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.461899) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2024-09-05 |