| NPI | 1801165758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015069) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041354939) |
| 363L00000X Nurse Practitioner (Licence: IL 209015069) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209015069) | |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2024-09-05 |