NPI | 1093359440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209028418) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: IL 041.447775) |
Enumeration Date | 2019-10-29 |
Last Update Date | 2023-12-01 |