| NPI | 1528350212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209008753) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 209.008753) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.008753) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2024-08-02 |