| NPI | 1275225468 |
|---|---|
| Former Name | CHRISTIAN GHILLIAM MATHIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MT 217058) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 28048) |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2024-12-23 |