| NPI | 1679702369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD R235106) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 10004511) |
| 363LF0000X Nurse Practitioner Family (Licence: DC RN1035154) | |
| 363LF0000X Nurse Practitioner Family (Licence: MD R235106) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2024-06-12 |