| NPI | 1013312156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 32096) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PR 71494G) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2021-02-26 |