| NPI | 1639721269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012406) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 173999) |
| 363L00000X Nurse Practitioner (Licence: NC 5012406) | |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2024-07-25 |