| NPI | 1558967653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R208287) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MD R208287) |
| Enumeration Date | 2020-12-05 |
| Last Update Date | 2023-09-18 |