| NPI | 1194246686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA APO9460) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP09460) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |