| NPI | 1073846440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209004954) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209004954) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2016-06-28 |