NPI | 1568830404 |
---|---|
Former Name | GRETA JOSEPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 1568830404) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209013110) |
Enumeration Date | 2015-09-09 |
Last Update Date | 2018-02-08 |