| NPI | 1164027876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 2486) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 2486) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-01-13 |