NPI | 1255734869 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000645) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 377.000624) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.011740) | |
Enumeration Date | 2014-09-27 |
Last Update Date | 2020-12-29 |