| NPI | 1720710791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209025763) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 209025763) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 041443879) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-12-14 |