| NPI | 1205301710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5011185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F08180846) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2022-05-17 |