| NPI | 1730759614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209025394) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH aprn.cpn.0029178) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2023-07-12 |