| NPI | 1104568369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041315090) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209025282) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-08-21 |