| NPI | 1629476718 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R218654)  | 
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: DC RN1022372)  | 
| Enumeration Date | 2014-12-05 | 
| Last Update Date | 2019-01-28 |