| NPI | 1215215009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024171804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024171804) |
| 363L00000X Nurse Practitioner (Licence: KY 3007008) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2023-12-07 |