NPI | 1720400898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209017229) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704302656) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209-017229) | |
Enumeration Date | 2014-01-09 |
Last Update Date | 2023-11-20 |