NPI | 1518322437 |
---|---|
Former Name | JESSICA HOMYAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209013105) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP15363) |
Enumeration Date | 2015-12-18 |
Last Update Date | 2022-10-24 |