| NPI | 1053941021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012736) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5012736) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012736) | |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2024-03-05 |