| NPI | 1215352554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024171501) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024171501) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2022-09-28 |