| NPI | 1790073740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-117454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 117454) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G164839) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-12-03 |