| NPI | 1770177172 | 
|---|---|
| Former Name | FARZANEH MOHAMMADI | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022654)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.022654)  | 
| 163W00000X Registered Nurse (Licence: IL 041.438415)  | |
| Enumeration Date | 2021-02-25 | 
| Last Update Date | 2024-11-07 |