| NPI | 1164978151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MS 901421) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MS 901421) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MS 901421) | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2022-05-18 |