| NPI | 1487990974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 368) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F54291) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2019-07-09 |