| NPI | 1831113059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.021887) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 5186) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-10-16 |