| NPI | 1093050841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021048982) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012036151) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.010250) | |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2022-07-15 |