| NPI | 1245790278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209019500) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041348381) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.002069) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-12-12 |