| NPI | 1205335957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 8836) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8836) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209017238) | |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2021-11-24 |