NPI | 1477973675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011484) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.387944) |
Enumeration Date | 2014-04-27 |
Last Update Date | 2016-06-30 |