| NPI | 1154806719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5011310) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AG09180175) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG09180175) | |
| Enumeration Date | 2018-09-30 |
| Last Update Date | 2021-08-13 |