| NPI | 1205378403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024182202) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 4880) |
| 363L00000X Nurse Practitioner (Licence: VA 0024182202) | |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2021-10-15 |