| NPI | 1629661012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0021480583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0021480583) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0021480583) | |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-09-25 |