NPI | 1932566031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95004145) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.407813) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2018-01-04 |