| NPI | 1073984878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5008212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F1015076) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5008212) | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2023-07-17 |