| NPI | 1285385880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.027771) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28198491A) |
| 363L00000X Nurse Practitioner (Licence: IN 71012304A) | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2023-07-17 |