NPI | 1689292542 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209024127) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041436980) |
Enumeration Date | 2020-07-08 |
Last Update Date | 2021-10-21 |