| NPI | 1760918403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209020588) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041402048) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2023-03-27 |