| NPI | 1710879408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.032806) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: IL 041.422110) |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-07-31 |