| NPI | 1558933150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 9456) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 9456) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9456) | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2022-11-30 |