| NPI | 1508269317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5007248) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 227872) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007248) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2021-03-03 |