NPI | 1033508478 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209-012444) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209012444) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2024-01-28 |