NPI | 1437634748 |
---|---|
Professional Name | N/A N/A |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017675) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 209017675) |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-06-15 |