| NPI | 1306542824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10005837) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 53-81928-021) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-06-18 |