NPI | 1245632959 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012489) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.190904) |
Enumeration Date | 2014-09-24 |
Last Update Date | 2015-01-24 |