| NPI | 1114006665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 22257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 508116) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 22257) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-12-21 |