| NPI | 1043525496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 309.004485) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.170670) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |