| NPI | 1255751095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.011311) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011311) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 309.007384) | |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2024-04-19 |