| NPI | 1164982914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22691) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 22691) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 22691) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2022-11-01 |