| NPI | 1982825832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 041-249007) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-002100) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-04-30 |