NPI | 1679118301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209020409) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020409) |
Enumeration Date | 2019-11-18 |
Last Update Date | 2021-07-29 |