| NPI | 1417373325 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 076708-23) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 076708-23) | 
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209011367) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209011367) | |
| Enumeration Date | 2014-03-16 | 
| Last Update Date | 2022-03-09 |