| NPI | 1275163255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 211491) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 211491) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 211491) | |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2023-11-28 |