| NPI | 1114328275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019005550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014023978) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209012039) | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2024-06-11 |