| NPI | 1225502768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2390242) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN169490) |
| 163W00000X Registered Nurse (Licence: GA RN169490) | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2025-01-21 |