| NPI | 1104363571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0994010-NP) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 136021) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2020-12-17 |