| NPI | 1992295596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209-017575) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017575) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2024-12-31 |