| NPI | 1609611649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.029963) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.029963) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-09-16 |