NPI | 1578095147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015308) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209015308) |
Enumeration Date | 2017-04-01 |
Last Update Date | 2019-06-18 |