| NPI | 1063976983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 903239) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 25447) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 110891) | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-08-05 |