| NPI | 1548700594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202104437NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP10567) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP10567) | |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2022-03-15 |