| NPI | 1528462439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.017670) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041413482) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2018-05-22 |