NPI | 1164723110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.008402) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008402) |
Enumeration Date | 2010-11-08 |
Last Update Date | 2023-10-13 |