NPI | 1659048015 |
---|---|
Former Name | BROOKE FIEDELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.022770) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041414299) |
Enumeration Date | 2021-08-24 |
Last Update Date | 2025-09-15 |