| NPI | 1730624701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024180249) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP9753) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024180249) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP9753) | |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2022-08-25 |