| NPI | 1134676117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024173892) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024173892) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024173892) | |
| 163W00000X Registered Nurse (Licence: VA 0001231741) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2024-04-23 |