| NPI | 1578019634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IL 041225083) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.014772) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209.014772) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2024-02-12 |