| NPI | 1407102056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 66608) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APN 001404) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2023-01-20 |