| NPI | 1619279502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R181471) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R181471) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R181471) | |
| Enumeration Date | 2010-11-26 |
| Last Update Date | 2024-08-25 |