NPI | 1639543937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277001341) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013581) |
Enumeration Date | 2015-11-24 |
Last Update Date | 2022-08-10 |