| NPI | 1619270725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.021291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041376323) |
| 363L00000X Nurse Practitioner (Licence: IL 209.021291) | |
| 363L00000X Nurse Practitioner (Licence: MI 4704365395) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704365395) | |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2020-10-20 |