NPI | 1225202492 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209006891) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209006891) |
164W00000X Licensed Practical Nurse (Licence: IL 209006891) | |
Enumeration Date | 2008-04-17 |
Last Update Date | 2018-10-19 |