| NPI | 1760872865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 70140) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 105690) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2022-09-30 |