| NPI | 1265897391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173128) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173128) |
| 163W00000X Registered Nurse (Licence: VA 0001200565) | |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2023-11-03 |