NPI | 1962922062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-015547) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.015547) |
Enumeration Date | 2017-06-21 |
Last Update Date | 2023-04-21 |