| NPI | 1871096016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.025715) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.462571) |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2022-09-13 |