NPI | 1083126353 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 2023125387) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014759) |
363LF0000X Nurse Practitioner, Family (Licence: IL 0192721) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: IL 377001655) | |
Enumeration Date | 2017-10-26 |
Last Update Date | 2023-11-22 |