| NPI | 1154939924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 227378) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209025968) | |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2023-10-31 |