| NPI | 1811612179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.003658) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.003658) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: IL 041461962) | |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2025-12-16 |