| NPI | 1104301142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5014426) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F06185563) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2023-01-25 |