NPI | 1376188110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022504) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041422080) |
363LF0000X Nurse Practitioner, Family (Licence: IL 2020089466) | |
Enumeration Date | 2019-11-15 |
Last Update Date | 2022-10-20 |