NPI | 1760097604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209021834) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.021834) |
163W00000X Registered Nurse (Licence: IL 041.431607) | |
Enumeration Date | 2020-09-08 |
Last Update Date | 2024-03-04 |