| NPI | 1063793289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN0995434) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 12614-NP) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2020-07-22 |