| NPI | 1679310197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS xxxxx) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS xxxxx) |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-08-05 |