| NPI | 1477144020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022767) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 277002436) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277002436) | |
| 363L00000X Nurse Practitioner (Licence: IL F01211025) | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-05-14 |