NPI | 1518670496 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026687) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.466086) |
Enumeration Date | 2023-01-05 |
Last Update Date | 2023-01-10 |