NPI | 1417591173 |
---|---|
Former Name | DIMI DAWN JOLLIFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209019681) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209019681) |
208000000X Pediatrics (Licence: IL 209019681) | |
Enumeration Date | 2019-11-05 |
Last Update Date | 2023-03-10 |