NPI | 1508049552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000764) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000764) |
Enumeration Date | 2007-12-13 |
Last Update Date | 2024-06-03 |