| NPI | 1265088058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 26417) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC MCHA-LKU90M) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2022-08-19 |