| NPI | 1205405644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.023336) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.509746) |
| 163W00000X Registered Nurse (Licence: TX 916707) | |
| 363L00000X Nurse Practitioner (Licence: IL 209.023336) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1035252) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |