| NPI | 1609330414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9013) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 9013) | |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2021-12-03 |