NPI | 1205406618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209023402) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.0402) |
Enumeration Date | 2021-06-28 |
Last Update Date | 2021-12-08 |