| NPI | 1487480752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2025034856) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MO 2019030421) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041561779) | |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2025-11-03 |