| NPI | 1225163744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5001612) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 200599) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 334577) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5001612) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-09-17 |