| NPI | 1497221162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209018397) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018397) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209018397) | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2025-02-03 |