| NPI | 1164718797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71006247A) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 041352323) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN189379) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2024-07-29 |