| NPI | 1093101958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023015552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015008646) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010222) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-05-03 |