| NPI | 1790897130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MO 62550) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 062550) |
| 363L00000X Nurse Practitioner (Licence: IL 041-318181) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-01-02 |