| NPI | 1063497469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024164480) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: VA CARN-AP) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0017137084) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164480) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2022-05-20 |