| NPI | 1053612382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024166549) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166549) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2025-01-05 |