| NPI | 1780131649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0001189033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024173910) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0001189033) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2022-03-16 |