NPI | 1316506082 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.019525) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.474969) |
Enumeration Date | 2019-06-06 |
Last Update Date | 2021-09-08 |