NPI | 1255941928 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209019888) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: IL 209.019888) |
Enumeration Date | 2020-08-06 |
Last Update Date | 2020-12-22 |