| NPI | 1811927205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 2628-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209004213) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 2628-033) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-07-21 |