| NPI | 1780052183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 55417) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 34742) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 55417) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2023-04-10 |