| NPI | 1407132897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000596) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-009096) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4674-33) | |
| Enumeration Date | 2011-10-29 |
| Last Update Date | 2022-08-11 |