| NPI | 1366962052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 37039) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4030575) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024174980) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2025-06-06 |