| NPI | 1205342052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5010098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5010098) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5010098) | |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2024-01-29 |