| NPI | 1437665411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209016903) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209016903) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2020-08-13 |