| NPI | 1245609775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R206030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1030978) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R206030) | |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2018-03-17 |