| NPI | 1013422302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024175690) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024175690) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175690) | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2024-04-19 |