| NPI | 1609307750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.023176) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.314114) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2021-06-07 |