| NPI | 1790049419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD AC005171) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 115077) |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2023-03-15 |