| NPI | 1356698112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R134072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN65139) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R134072) | |
| Enumeration Date | 2012-08-11 |
| Last Update Date | 2020-08-11 |