| NPI | 1629527650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2016035068) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016035068) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015075 041.41117) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209015075) | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2024-05-03 |