| NPI | 1497131320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 111874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111874) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95003676) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2022-01-02 |