| NPI | 1326597246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP006440B) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: PA TP006440B) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 5018360) | |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2023-07-10 |