| NPI | 1407606486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 27936) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5019957) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5019957) | |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-04-30 |