| NPI | 1841636503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209019256) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041244670) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-08-06 |