NPI | 1336502681 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209014096) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014096) |
Enumeration Date | 2016-04-04 |
Last Update Date | 2021-09-21 |