NPI | 1790391977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209021732) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020024176) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209021732) | |
Enumeration Date | 2020-09-22 |
Last Update Date | 2023-03-31 |