| NPI | 1134675069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7025) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MT NUR-APRN-LIC-104940) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2020-08-07 |