| NPI | 1679987432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NE 111672) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 111672) |
| 363LF0000X Nurse Practitioner Family (Licence: NE 111672) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-07-21 |