NPI | 1700365137 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-018308) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041315260) |
Enumeration Date | 2018-08-07 |
Last Update Date | 2021-02-18 |