| NPI | 1710562988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5014755) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 245430) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014755) | |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2024-03-01 |