NPI | 1992363584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.027510) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041414184) |
Enumeration Date | 2019-05-30 |
Last Update Date | 2024-10-25 |