| NPI | 1619563798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010613) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017915) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11010613) | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2023-06-26 |