| NPI | 1457802498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024174051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R182600) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174051) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2023-05-12 |