| NPI | 1407393408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5016152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016152) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22129) | |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2025-04-17 |