NPI | 1912927062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 041-261725) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-003409) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2021-04-26 |