| NPI | 1104353705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-128088) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 85531) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 30400) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-06-12 |