NPI | 1972907459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 277002454) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209011995) |
Enumeration Date | 2014-10-13 |
Last Update Date | 2023-09-19 |