| NPI | 1538701529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID CNP67339) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8710894-3102) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID CNP67339) | |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2021-07-27 |