| NPI | 1861987604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 23611) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23611) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017845) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209017845) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2021-10-06 |