NPI | 1689208928 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209020614) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.020914) |
Enumeration Date | 2020-02-25 |
Last Update Date | 2023-03-07 |