NPI | 1336627165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209017907) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017907) |
Enumeration Date | 2018-08-02 |
Last Update Date | 2023-03-07 |