| NPI | 1619179041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.006961) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041-306705) |
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: IL 209.006961) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-02-07 |