| NPI | 1679060925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R221720) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD F04180018) |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2022-11-08 |