| NPI | 1275703803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71005012A) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IN 71005012A) |
| 363L00000X Nurse Practitioner (Licence: IN 71005012A) | |
| 363L00000X Nurse Practitioner (Licence: IL 209-006773) | |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2023-08-28 |