| NPI | 1679850044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/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 |