| NPI | 1265951792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348428) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016646) | |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2023-10-19 |