NPI | 1588122568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018924) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209018924) |
Enumeration Date | 2019-03-07 |
Last Update Date | 2022-04-20 |