| NPI | 1831639384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.015662) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.015662) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015662) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.015662) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2025-08-04 |