| NPI | 1639486137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277-000054) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277-000054) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP8085) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8085) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 277-000054) | |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2020-05-20 |