| NPI | 1013512243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209022486) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041342473) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209022486) | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2024-05-20 |