| NPI | 1023618659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 53450) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 53450) |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2023-07-03 |