| NPI | 1588762298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 277003294) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277003294) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209005376) | |
| 363L00000X Nurse Practitioner (Licence: IL 277003294) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2026-07-13 |