| NPI | 1932716925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.022078) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.438629) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |