| NPI | 1780864025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024176477) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 22191) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176477) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 22191) | |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2023-07-10 |