NPI | 1053673194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209032088) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.385931) |
Enumeration Date | 2012-06-14 |
Last Update Date | 2025-04-16 |