| NPI | 1336522275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015014624) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 309.009327) |
| 363L00000X Nurse Practitioner (Licence: IL 209.012926) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-09-30 |