NPI | 1790258473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018588) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209018588) |
Enumeration Date | 2019-01-06 |
Last Update Date | 2023-07-06 |