| NPI | 1306220793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209016279) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 692485) |
| 163W00000X Registered Nurse (Licence: CA 95104478) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2022-06-21 |