NPI | 1629730585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209024307) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041342884) |
363L00000X Nurse Practitioner (Licence: IL 209024307) | |
Enumeration Date | 2021-10-07 |
Last Update Date | 2022-02-23 |