NPI | 1164905014 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019323) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.379038) |
Enumeration Date | 2018-09-06 |
Last Update Date | 2022-04-20 |