| NPI | 1508437484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209024682) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.441397) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2022-03-30 |