NPI | 1336539980 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012196) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041371175) |
Enumeration Date | 2015-02-03 |
Last Update Date | 2019-05-01 |