NPI | 1780217992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: IL 209.019376) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.019376) |
363LG0600X Nurse Practitioner Gerontology (Licence: IL 209.019376) | |
Enumeration Date | 2020-02-16 |
Last Update Date | 2020-02-16 |