| NPI | 1659377752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 129159) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 129153) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022035162) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2022-12-19 |