| NPI | 1730501214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013813) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 265899) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5013813) | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2021-02-25 |