| NPI | 1902695208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.032371) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IL 041.497738) |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-15 |