NPI | 1700169737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028308) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4595) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4595-33) | |
Enumeration Date | 2011-09-26 |
Last Update Date | 2024-01-22 |