NPI | 1407517923 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025028) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.455975) |
Enumeration Date | 2022-01-06 |
Last Update Date | 2023-09-15 |