| NPI | 1730506981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP07703) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN126015) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R868164) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-03-14 |