| NPI | 1669840641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R176269) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11025478) |
| 163W00000X Registered Nurse (Licence: MD R176269) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2024-11-20 |