NPI | 1013349158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 209010574) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010574) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209010574) | |
Enumeration Date | 2013-07-31 |
Last Update Date | 2024-03-05 |