NPI | 1194149302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010815) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041355848) |
Enumeration Date | 2014-02-07 |
Last Update Date | 2018-12-03 |