| NPI | 1477229573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R39988) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: ND R39988) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-25 |