| NPI | 1861911026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277.000562) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016273) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000562) | |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2024-10-24 |