NPI | 1639621071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014944) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014944) |
Enumeration Date | 2016-11-02 |
Last Update Date | 2021-08-09 |