| NPI | 1376064154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G120727) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA G120727) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184682) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2024-05-02 |