NPI | 1447851472 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020415) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024048558) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2024048558) | |
Enumeration Date | 2020-11-05 |
Last Update Date | 2024-12-13 |