| NPI | 1730530486 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024173136)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC001803)  | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC001803)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173136)  | |
| Enumeration Date | 2016-06-23 | 
| Last Update Date | 2017-03-17 |