| NPI | 1861965543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1133284) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 277001168) |
| 363L00000X Nurse Practitioner (Licence: IL 209018494) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 277001168) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209018494) | |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2025-08-11 |