NPI | 1710603121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026136) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209026136) |
Enumeration Date | 2022-10-17 |
Last Update Date | 2024-09-25 |