| NPI | 1568196012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209025463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025463) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-04-14 |