| NPI | 1215554746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209030357) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007771) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2024-08-26 |