NPI | 1366892218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014315) |
Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: IL 041264588) |
Enumeration Date | 2016-06-21 |
Last Update Date | 2021-04-21 |