| NPI | 1538753397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209026309) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-180603) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2022-11-18 |