| NPI | 1295134492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA 20206902) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN106665) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN106665) | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2021-05-10 |