NPI | 1821360520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 309.018742) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.389928) |
Enumeration Date | 2012-01-27 |
Last Update Date | 2024-04-05 |