NPI | 1205145299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209014981) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404564) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209014981) | |
Enumeration Date | 2010-09-25 |
Last Update Date | 2022-12-05 |