| NPI | 1215949789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.004876) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209004876) | 
| Enumeration Date | 2006-08-13 | 
| Last Update Date | 2024-12-20 |