| NPI | 1588370605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209026575) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1093928) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4014800) | |
| Enumeration Date | 2023-01-24 | 
| Last Update Date | 2024-01-29 |