NPI | 1619491354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209016221) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041312276) |
163W00000X Registered Nurse (Licence: CA 95237438) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209016221) | |
Enumeration Date | 2017-08-02 |
Last Update Date | 2021-05-15 |