| NPI | 1689927766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209013961) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-376134) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209013961) | |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2018-05-01 |