| NPI | 1124855788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209031506) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-340104) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2025-03-06 |