| NPI | 1720734700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71013475A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0033562) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2023-08-04 |