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 |