NPI | 1356904148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209019404) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209019404) |
Enumeration Date | 2019-04-17 |
Last Update Date | 2023-03-13 |