| NPI | 1336626738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018027751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018027751) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 309.014223) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2023-03-07 |