| NPI | 1629475462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G157435) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A157005) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2020-02-06 |