| NPI | 1508257221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5007563) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC BLAN-GIKLC9) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2022-07-24 |