| NPI | 1659476240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NC 2020114621) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: NC 198881) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5004910) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-05-08 |