| NPI | 1467872697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN238103) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN238103) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024171215) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2018-09-06 |