NPI | 1336604784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277001650) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.001650) |
Enumeration Date | 2019-02-08 |
Last Update Date | 2024-08-23 |