| NPI | 1659948396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.025640) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041481067) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2022-08-04 |