| NPI | 1013426642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ MSLN45738ID) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: UT 10898232-8900) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2023-10-05 |