| NPI | 1730348327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 30260) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-RN-LIC-30260) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2024-07-02 |