NPI | 1619211786 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.009918) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IL 209009918) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2022-04-08 |