| NPI | 1104382639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5011409) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 5011409) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5011409) | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-01-28 |