NPI | 1619456548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209017917) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL F06180151) |
Enumeration Date | 2018-08-10 |
Last Update Date | 2020-07-11 |