NPI | 1205405644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.023336) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.509746) |
163W00000X Registered Nurse (Licence: TX 916707) | |
363L00000X Nurse Practitioner (Licence: IL 209.023336) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1035252) | |
Enumeration Date | 2021-06-21 |
Last Update Date | 2021-06-21 |