| NPI | 1144864653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012465) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012465) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5012465) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5012465) | |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2023-07-07 |