NPI | 1265962336 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277003887) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.023143) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209015966) | |
Enumeration Date | 2017-06-12 |
Last Update Date | 2025-06-20 |