| NPI | 1679602536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN155003) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN 155003) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 11507) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-04-19 |