NPI | 1801165758 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015069) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041354939) |
363L00000X Nurse Practitioner (Licence: IL 209015069) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209015069) | |
Enumeration Date | 2011-12-21 |
Last Update Date | 2024-09-24 |