| NPI | 1720411432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R219103) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0043098) |
| 163W00000X Registered Nurse (Licence: PA RN642929) | |
| 363L00000X Nurse Practitioner (Licence: MD R219103) | |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2024-04-06 |