NPI | 1942951553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 13196457-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.520054) |
163W00000X Registered Nurse (Licence: WI 25634630) | |
363LF0000X Nurse Practitioner, Family (Licence: IL 209026151) | |
Enumeration Date | 2022-01-14 |
Last Update Date | 2024-10-18 |