NPI | 1982153995 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209015928) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015928) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-140763) | |
Enumeration Date | 2016-10-03 |
Last Update Date | 2018-12-13 |