NPI | 1811528904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209028513) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309203) |
Enumeration Date | 2020-01-28 |
Last Update Date | 2024-09-26 |