| NPI | 1336799634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R212861) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MD R212861) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2025-04-17 |