| NPI | 1174148340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71010785A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3014693) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2024-11-20 |