| NPI | 1083859714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10645070-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC000882) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167173) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC000882) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA AC000882) | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2020-11-20 |