| NPI | 1649996828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5017091) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC BUCK-L9PPC) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-26 |