NPI | 1225493364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015066) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041327709) |
Enumeration Date | 2015-12-16 |
Last Update Date | 2022-06-03 |