NPI | 1225514722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017864) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018016871) |
Enumeration Date | 2018-07-17 |
Last Update Date | 2018-07-17 |