| NPI | 1659463032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA MA001329L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA001329L) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-08-03 |