| NPI | 1073155248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 212163) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD 212163) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2022-01-21 |