| NPI | 1568844652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015016105) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP8542) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015016105) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2019-10-09 |