| NPI | 1548651979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277001490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 14955) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 277001490) | |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2025-02-25 |