NPI | 1952797383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 309.008691) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012702) |
363LF0000X Nurse Practitioner, Family (Licence: IL 309.008691) | |
Enumeration Date | 2015-04-13 |
Last Update Date | 2021-05-26 |