| NPI | 1063969111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R189459) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R189459) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: MD R189459) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2023-05-12 |