| NPI | 1114473816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173726) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01563) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173726) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-07-10 |