| NPI | 1336687144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 377002534) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.391640) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2023-06-27 |