| NPI | 1215760483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209031244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041463678) |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2025-01-13 |