| NPI | 1235714510 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5014209) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 5014209) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2025-02-03 |