| NPI | 1508401696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0024176694) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176694) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2022-06-07 |