NPI | 1275076499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014886) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041384991) |
Enumeration Date | 2016-11-19 |
Last Update Date | 2019-09-12 |