| NPI | 1134647688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5010039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 311120) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5010039) | |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2024-03-22 |