| NPI | 1700331311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.029180) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A119964) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A119964) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029180) | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2024-01-17 |