| NPI | 1154681591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209009269) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009269) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2022-03-24 |