NPI | 1649903188 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025172) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 209.025172) |
2088P0231X (Licence: IL 209.025172) | |
363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209.025172) | |
Enumeration Date | 2022-07-01 |
Last Update Date | 2022-10-24 |