| NPI | 1083048748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: DE LP-000135) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: DE LP-000135) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: DE LP-000135) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE LP-00013) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE LP-000135) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: DE LP-00013) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2021-12-05 |