NPI | 1689061855 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277001961) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012421) |
Enumeration Date | 2015-04-24 |
Last Update Date | 2023-07-18 |