NPI | 1629404298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.010422) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.010422) |
Enumeration Date | 2013-09-16 |
Last Update Date | 2024-12-26 |