| NPI | 1528510674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95011628) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.015016) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2019-05-20 |