| NPI | 1467580555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 3378) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 3378) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 3378) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: SC 3378) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2019-11-17 |