| NPI | 1790069540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277000002) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 277000002) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2020005254) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020005255) | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2025-11-09 |