| NPI | 1710544580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10028400) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 10556) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012317) | |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2024-09-16 |