| NPI | 1124571674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NC 500701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 500701) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 500701) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2023-01-06 |