| NPI | 1770879074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA ap05552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN094823-AP05552) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-01-27 |