| NPI | 1679850044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NM CNP02817) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NM CNP02817) |
| 363L00000X Nurse Practitioner (Licence: SC 17616) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NM CNP02817) | |
| 363LF0000X Nurse Practitioner Family (Licence: NM CNP02817) | |
| Enumeration Date | 2011-11-12 |
| Last Update Date | 2025-09-05 |