| NPI | 1710487004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R45930) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-123276) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 35380) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9888) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ND R45930) | |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2024-03-19 |