| NPI | 1508337056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.018539) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.473303) |
| 163W00000X Registered Nurse (Licence: TN 225340) | |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2020-02-13 |