| NPI | 1164994000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024176979) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024176979) |
| 363L00000X Nurse Practitioner (Licence: VA 0024176979) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2024-05-22 |