| NPI | 1104221613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R189744) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R189744) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R189744) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2021-02-04 |