| NPI | 1679899405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-008070) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.008070) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209-008070) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2018-11-26 |