NPI | 1740633510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209014474) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 20914474) |
363LF0000X Nurse Practitioner Family (Licence: IL 209014474) | |
Enumeration Date | 2016-07-18 |
Last Update Date | 2021-06-04 |